On May 21, the House Small Business Subcommittee on Rural and Urban Entrepreneurship held a hearing on competitive bidding to determine its impact on small business.

In opening remarks, Subcommittee Chairman Heath Shuler, D-N.C., said it was unclear how CMS would be able to deliver on its promise of reducing costs, improving effectiveness and ensuring access to care for seniors “without driving small health care providers out of business and limiting access to care.”

The subcommittee also heard from several small providers representing HME.

“We believe that the Medicare bidding program will radically change the HME marketplace and dismantle the nation's home medical infrastructure if implemented in its current form,” said Casey Hite, vice president of Aeroflow Healthcare in Asheville, N.C.

“Home care companies currently provide 24-hour, emergency on-call service to assist patients with trouble-shooting equipment problems, improper use, equipment failures, and we provide clinical assessments by respiratory therapists and registered nurses. Who is going to do all of this when patients own their equipment?” Julie Weidemann, director of Palmer Home Medical Supply in West Union, Iowa, asked the subcommittee.

And Gary Gilberti, president and CEO of Chesapeake Rehab Equipment, Baltimore, Md., told the legislators that “competitive bidding will not work for complex rehab items and that ultimately it will cause an access issue for Medicare beneficiaries with disabilities.”

It looks like they found a friend in Shuler, who issued a statement after the hearing referring to problems in round one: “When serious challenges arise in the early stages of any process, you focus on fixing them. You don't make them worse by expanding the program and extending negative impacts to new markets. CMS needs to take a careful look at this initiative before it moves any further. Anything less hurts small businesses, patients and the economy, and is unacceptable.”